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Prognostic factors in allo-SCT of elderly patients with AML.

Research paper by J J Krauter, K K Wagner, M M Stadler, E E Dammann, M M Zucknick, M M Eder, S S Buchholz, E E Mischak-Weissinger, B B Hertenstein, A A Ganser

Indexed on: 16 Jun '10Published on: 16 Jun '10Published in: Bone Marrow Transplantation



Abstract

The prognosis of elderly patients with AML after chemotherapy is poor. Allo-SCT is feasible in these patients, but data on prognostic factors and outcome are limited. We analyzed all 102 AML patients ≥55 years, who underwent allo-SCT at our institution from 1997 to 2008. OS and relapse-free survival (RFS) rates at 3 years are 39 and 37%, respectively. Multivariate analysis for OS revealed age ≥60 years and active (refractory or untreated before allo-SCT) or advanced (>CR1) disease as adverse prognostic factors. Patients transplanted in CR1 had a 3-year OS of 67 vs 27% for patients with active/advanced disease. Multivariate analysis for RFS revealed active/advanced disease as the only adverse factor. Patients transplanted in CR1 had a 3-year RFS of 70 vs 22% for patients with active/advanced disease. In all, 17% of patients suffered from acute GVHD ≥grade II. The risk for severe acute GVHD was increased after allo-SCT from mismatched donors. Nonrelapse mortality (NRM) was 23% at 1 year. The only risk factor for NRM was active/advanced disease. In conclusion, allo-SCT from related or unrelated donors yields very good results in elderly AML patients transplanted in CR1. Disease status at transplantation is the most important prognostic factor for transplantation success.

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